eMedicine Specialties > Thoracic Surgery > Tumors

Thymic Tumors: Follow-up

Author: Dale K Mueller, MD, Associate Professor of Surgery, Section Chief, Department of Surgery, University of Illinois at Peoria; Co-Medical Director, Thoracic Center of Excellence, Vice-Chair, Department of Cardiovascular Medicine and Surgery, OSF St Francis Medical Center; Cardiovascular and Thoracic Surgeon, HeartCare Midwest, SC
Contributor Information and Disclosures

Updated: Sep 3, 2008

Outcome and Prognosis

Prognosis after resection of a mediastinal tumor varies widely depending on the type of lesion resected. After resection of mediastinal cysts and benign tumors, prognosis is generally excellent. Thymic neoplasms included in this group are thymolipomas. Prognosis after treatment of malignant mediastinal tumors depends on the type of lesion, its biological behavior, and the extent of the disease present.

Thymoma

Thymomas are not considered benign neoplasms. Survival rates associated with tumors that are encapsulated or stage I is 95-97% at 5 years and 80-95% at 10 years.

Invasive or stage II tumors are associated with a reduced 5-year survival rate of 60-70% and a 10-year survival rate of 40-50%.

Survival rates for stage III tumors are reported to be less than 60% at 5 years and 14% at 10 years.

Survival rates for stage IVA tumors have been reported at 40% for 5 years and 0% at 10 years.

Other thymic malignancies

Squamous cell carcinoma of the thymus is quite rare, with fewer than 200 cases reported in the literature. Prognosis is considered excellent in cases of well-differentiated squamous cell tumors found and resected early. Poorly differentiated tumors have a uniformly poor prognosis.

The overall cure rate for neuroendocrine tumors of the thymus is low. One series reports a 13% 5-year survival rate.

The survival rate for patients with thymic epithelial neoplasms is 77% at 5 years. Risk factors with prognostic significance included staging and histologic type.

Future and Controversies

A number of exciting advances have been made in areas of diagnostic imaging, biologic analysis, and therapy.

Emerging diagnostic modalities such as PET scanning and other radionuclide studies may assist in the diagnosis of specific neoplasms and in posttherapy surveillance for recurrent disease. PET scanning has preliminarily demonstrated the ability to differentiate benign thymomas and malignant thymomas.

Numerous biological markers have been identified for many tumors and will play a vital role in better identifying individual neoplasms so that treatment can be optimized.

Use of VATS and robotic technology has entered the armamentarium of the thoracic surgeon with respect to the treatment of a number of mediastinal diseases. This modality is already commonly used for biopsy of masses and lymph nodes. It has also been described for resection of various mediastinal cysts, mediastinal parathyroid adenomas, and localized benign tumors of the posterior mediastinum, such as ganglioneuromas. The success of these modalities will be determined by data obtained in the long-term follow-up of cases. Because these neoplasms grow slowly, these data are not yet available.

 
Acknowledgments

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author Jane M Eggerstedt, MD to the development and writing of this article.



More on Thymic Tumors

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References
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Further Reading

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Keywords

thymoma, thymic tumor, benign tumor, tumor, thymic cyst, carcinoma of the thymus, carcinoid tumor of the thymus, thymolipomas, mediastinal surgery, mediastinal tumor, cystic tumor, mediastinum surgery, dermoid cyst, teratoma, mediastinal mass, mediastinal tumor, thymic carcinomas, thymic neuroendocrine tumors, thymic hyperplasia, thymic carcinoids, myasthenia gravis, thymic rebound, thymus neoplasm, thymus gland

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Contributor Information and Disclosures

Author

Dale K Mueller, MD, Associate Professor of Surgery, Section Chief, Department of Surgery, University of Illinois at Peoria; Co-Medical Director, Thoracic Center of Excellence, Vice-Chair, Department of Cardiovascular Medicine and Surgery, OSF St Francis Medical Center; Cardiovascular and Thoracic Surgeon, HeartCare Midwest, SC
Dale K Mueller, MD is a member of the following medical societies: American College of Chest Physicians, American College of Surgeons, American College of Surgeons, American Medical Association, American Medical Writers Association, Chicago Medical Society, Illinois State Medical Society, and Society of Thoracic Surgeons
Disclosure: Nothing to disclose.

Medical Editor

Richard Thurer, MD, B and Donald Carlin Professor of Thoracic Surgical Oncology, Miller School of Medicine, University of Miami
Richard Thurer, MD is a member of the following medical societies: American Association for Thoracic Surgery, American College of Chest Physicians, American College of Surgeons, American Medical Association, American Thoracic Society, Florida Medical Association, Society of Surgical Oncology, and Society of Thoracic Surgeons
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Daniel S Schwartz, MD, FACS, Clinical Assistant Professor of Cardiothoracic Surgery, New York University School of Medicine; Consulting Staff, Department of Surgery, Division of Thoracic Surgery, North Shore University Hospital/Long Island Jewish Medical Center
Daniel S Schwartz, MD, FACS is a member of the following medical societies: American Association for the Advancement of Science, American College of Cardiology, American College of Chest Physicians, American College of Surgeons, American Diabetes Association, American Heart Association, American Medical Association, Association for Academic Surgery, and Society of Thoracic Surgeons
Disclosure: Nothing to disclose.

CME Editor

Rajalaxmi McKenna, MD, FACP, Consulting Staff, Department of Medicine, Southwest Medical Consultants, SC, Good Samaritan Hospital, Advocate Health Systems
Rajalaxmi McKenna, MD, FACP is a member of the following medical societies: American Society of Clinical Oncology, American Society of Hematology, and International Society on Thrombosis and Haemostasis
Disclosure: Nothing to disclose.

Chief Editor

Mary C Mancini, MD, PhD, Professor, Department of Surgery, Louisiana State University Health Sciences Center
Mary C Mancini, MD, PhD is a member of the following medical societies: American Heart Association, American Medical Association, American Thoracic Society, Association for Academic Surgery, Association for Surgical Education, International College of Surgeons, International Society for Heart and Lung Transplantation, New York Academy of Sciences, Phi Beta Kappa, and Southern Thoracic Surgical Association
Disclosure: Nothing to disclose.

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